Improving psychological outcomes for orphans living with HIV in Tanzania through a novel intervention to improve resilience: findings from a pilot RCT
Improving psychological outcomes for orphans living with HIV in Tanzania through a novel intervention to improve resilience: findings from a pilot RCT
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DOI：
10.1080/09540121.2018.1533630
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发表时间：
2019-03-04
影响因子：
1.7
通讯作者：
Miti, Elvis
中科院分区：
文献类型：
--
作者：
Harding, Richard;Wei, Gao;Miti, Elvis
父母死亡和艾滋病毒与撒哈拉以南非洲孤儿的精神健康状况不良有关。本研究的目的是评估理论为基础的干预孤儿在坦桑尼亚的治疗，在可行性，可接受性和初步成果。一个试点随机对照试验与巢式焦点小组（FGD）分配48名儿童的日常护理或住宅的“记忆工作疗法”。儿童在T0（基线），T1（干预后2周）和T2（从T0开始9周）完成了结果测量。40%的合格儿童表示同意。T1干预对所有总测量结果均有影响：简明症状量表d = 0.99，p <0.001; Rosenberg自尊量表d = 0.65，p = 0.001;优势和困难问卷d = 0.64，p = 0.002;儿童自我效能问卷的“社交”和“情感”分量表，分别为d = 0.54，p = 0.008和d = 0.63，p = 0.002。在T2时，所有测量均保持显著效应，SES效应从中等到大逐渐增加（T1 = 0.65，T2 = 1.33）。FGD的数据发现，儿童重视满足其基本需求的平静环境，使他们能够反思，突出支持资源，并加强识别个人技能的能力。该干预措施具有较强的可行性和可接受性，没有流失或缺失数据。记忆工作疗法具有很高的潜在效应大小，应该在充分有效的试验中进行测试。临床trials.gov NCT 02180750。
Parental death and HIV are associated with poor mental health for orphans in sub-Saharan Africa. This study aimed to evaluate a theory-based intervention for orphaned children on treatment in Tanzania, in terms of feasibility, acceptability and preliminary outcomes. A pilot RCT with nested focus group (FGD) allocated 48 children to usual care or residential "Memory Work Therapy". Children completed outcome measures at T0 (baseline), T1 (2 weeks following intervention) and T2 (9 weeks from T0). Forty percent of eligible children assented. T1 intervention effects were found on all total measures: Brief Symptom Inventory d = 0.99, p < .001; Rosenberg Self Esteem Scale d = 0.65, p = .001; Strengths and Difficulties Questionnaire d = 0.64, p = .002; Self-efficacy questionnaire for children both "social" and "emotional" subscales, d = 0.54, p = .008 and d = 0.63, p = .002, respectively. At T2, significant effects remained for all measures and SES effect increased from medium to large (T1 = 0.65, T2 = 1.33). FGD data found children valued a calm environment that met their basic needs, enabling them to reflect, highlight support resources, and strengthen ability to recognize personal skills. The intervention has strong feasibility and acceptability, with no attrition or missing data. Memory Work Therapy has high potential effect size and should be tested in a fully powered trial. Clinical trials.gov NCT02180750.